Purpose :
To describe and analyze the clinical entities, causes, and outcomes of medical malpractice lawsuits in uveitis to inform clinical decision-making and guide risk management.

Methods :
Retrospective review of the WestLaw® database for United States malpractice verdicts, rulings, settlements related to ophthalmology in the United States from 1930-2014. Data including subspecialty focus of uveitis, patient age, procedure performed (if applicable), plaintiff legal allegation, nature of injury, verdicts, indemnities, and plaintiff award were collected and analyzed. All monetary awards were adjusted to 2015 United States dollars.

Results :
Twenty-four cases met inclusion criteria, 50% of cases were infectious uveitis. Overall, 66.7% of outcomes favored the defendant. The most common diagnoses leading to litigation were viral retinitis (29.1%), iritis (8.3%), syphilis (8.3%), and toxoplasmosis (8.3%). Two cases (8.3%) were related to adverse events associated with medical therapy, and one case suggested poor physican-patient rapport as the root of litigation. A total of 6 suits (25%) resulted in settlement, with mean adjusted indemnities of $724,302.19 (median, $409,389.91; range, $127,837.49 - 2,021,887.04). Two cases (8.3%) resulted in plaintiff verdict, with adjusted awards of $1,399,800.29 and $630,799.36.

Conclusions :
Ophthalmologists managing uveitis risk malpractice litigation secondary to high morbidity and the need for complex decision making, especially with infectious entities. Despite being a rare diagnosis, viral retinitis (especially acute retinal necrosis) is the most common clinical entity associated with claims in uveitis, and should be considered in the initial management of any patient with uveitis. Malpractice risk may also be minimized by educating patients about the potential adverse effects of medication, testing for syphilis early in management, and maintaining a positive therapeutic relationship.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.